| NPI | 1619103389 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OR MD172570) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: VT 0420012472) |
| 207Q00000X Family Medicine (Licence: OR LL18409) | |
| Enumeration Date | 2009-06-08 |
| Last Update Date | 2021-03-24 |